Credentialing Specialist
What you'd do
This position serves as a Credentialing Specialist within the Division of Clinical Services at Red Lake Service Unit in Red Lake, Minnesota. The incumbent coordinates provider credentialing and privileging activities, ensures compliance with applicable standards and requirements, and supports medical staff credentialing processes to maintain provider readiness and organizational compliance. A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021).
Major duties
Independently prepares and maintains Medical Staff credentialing and privileging files for review and presentation to medical staff, clinical director, and governing board. Provides complete, accurate information that allows appropriate decision-making to the satisfaction of the Clinical Director, Chief Executive Officer, Medical Staff, and/or the Governing Body. Ensures the integrity of all paper and/or electronic provider files in accordance with bylaws, policies, and procedures. When applicable and in accordance with the centralized verification organization policy, notify all appropriate parties of any actions taken. Conducts all ongoing monitoring of national practitioner data banks, the Office of Inspector General, and licensure. Ensures compliance with federal accreditation and organizational requirements to support provider credentialing and survey readiness. Performs all centralized credentialing functions across the organization. This includes application verification, data entry, review, and organization of virtual committees within the MD Staff credentialing software package.
What you need to qualify
To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. MINIMUM QUALIFICATIONS: GS-09: Master's or equivalent graduate degree or 2 full years of progressively higher level graduate education leading to such a degree or LL.B. or J.D or One (1) year of Specialized Experience. Specialized Experience: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Processing credentialing and privileging actions for medical staff; verifying licensure, education, and training through appropriate sources; reviewing provider credentialing files for accuracy, completeness, and compliance with established policies; monitoring provider eligibility and compliance; preparing reports and documentation for leadership or governing bodies; and identifying discrepancies and recommending corrective actions. In describing your experience, please be clear and specific. We do not make assumptions regarding your experience. Your resume must support your application responses. Time In Grade Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP). You must meet all qualification requirements within 30 days of the closing date of the announcement.
Before you apply
Federal applications are different: your resume should be 3–5 pages and mirror the language of this announcement. Read our federal resume guide first — it's the #1 reason qualified people get screened out.
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